Individual
LISA JAHRSDOERFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
172 E MAIN ST, HUNTINGTON, NY 11743
(631) 385-0022
Mailing address
172 E MAIN ST, HUNTINGTON, NY 11743-2948
(631) 385-0022
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
310938
NY
Other
Enumeration date
10/06/2022
Last updated
02/09/2023
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